In order to assess the effects of diazepam and meperidine as premedication for upper gastrointestinal endoscopy, eighty eight patients undergone an elective upper gastrointestinal endoscopy were studied. Studied patients were divided into two groups; one group was premedicated with buscopan and stropine(group I), and the other group was premedicated with diazepam and meperidien (group II). The results obtained were summarized as follows; 1) 83.0% of the group II (44/53) did not eomplain any discomfort by the procedure, but only 23.9% (8/35) of the group I showed no discopmort. The difference between two groups is statiatieally significant (p<0.005). 2) In 41 patients with previous experience of endoscopy, 22 patients from 27 of the graup Il(81.5%) did not feel any discomfort but it wes only 3 patients among 14 of the group I (21.4%) who did not feel discomfart (p<0,005). 3) In 47 patients without previous experience of endoscopy, 23 patients from 26 of the group II (88. 5%) did not show discomfort but it way only 5 patients among 21 of the group I (23.7%) (p<0.005). 4) In the patients with previous experience of endoscopy, 21 patients among 27 of the group II (77. 8%) felt better than that of the previous experience but it was only 3 patients among 14 of the group I (21.4%) (p<0.005). From the above results, we would emphasize that it is more effective to use diazepam and, meperidien as premendication for the gastrointestinal endoscopic procedure since it removes pstients apprehension rendering them a good cooperation with very minimal side effects,
Butylscopolammonium Bromide ; Diazepam ; Endoscopy ; Endoscopy, Gastrointestinal ; Humans ; Meperidine ; Premedication*

AIM: To study the chemical constituents and their anti-amnesic effect from the hooks of Uncaria rhynchophylla. METHODS: The isolation of compounds was performed by chromatographic techniques and their structures were identified on the basis of spectral analysis. Their ameliorating effects on scopolamine-induced memory impairment in vivo using a Morris water-maze task and passive avoidance task system were evaluated. RESULTS: Activity-guided fractionation of the total extracts resulted in the isolation of four constituents, trans-anethole (1), p-anisaldehyde (2), estragole (3), and 3-oxo-olean-12-en-28-oic acid (4), which were found for the first time from this plant. CONCLUSION Compound 1 exhibited a better memory enhancing effect than tacrine, a positive agent, at the same dose in the passive avoidance test and a similar property in the water-maze test, and its action may be mediated, in part, by the acetylcholine enhancing cholinergic nervous system.
Animals ; Humans ; Male ; Memory ; drug effects ; Memory Disorders ; drug therapy ; Molecular Structure ; Plant Extracts ; administration & dosage ; chemistry ; isolation & purification ; Rats ; Rats, Sprague-Dawley ; Scopolamine ; adverse effects ; Uncaria ; chemistry

BACKGROUND: The maximal removal rate of indocyanine green (ICG Rmax), which has been used as a useful indicator of quantitative assessment of the hepatic function, has some disadvantages such as high cost, requirement of multiple sampling, and long turn-around time. This study was designed to clarify that the measurement of the lidocaine metabolite, monoethylglycinekylidide (MEGX) test, can replace the ICG Rmax. And in healthy adults, MEGX forma pion was measured and compared according to methods of measurement and serf. METHOD: In 18 patients to whom ICG Rmax test was requested, ICG Rmax test was carried out at two doses of 0.5 mg/kg and 5 mg/kg and MEGX formation after 15 minute of 1 mg/kg lidocaine Injection was measured by fluorescence polarization immunoassay (FPIA) method. The correlation between them was analyzed, To 25 healthy volunteers included in this study as normal control, lidocaine was given intravenously at, a dose of 1 mg/kg and MEGX forma pion was measured IS and 30 minute later (MEGX15, MEGX30) using both high performance liquid chromatography (HPLC) and FPIA methods. RESULT: Patient group resealed significant correlation between ICG Rmax and MEGX15 (r=0.7674, p<0.001) and also between ICG Rl5 and MEGX15 (r=0.5612, p=0.008). There was significant difference between MEGX15 of 9 patients with chronic liver diseases and those of normal controls (22.24+/- 13.18 and 35.40+/- 14.43 ng/mL, respectively) (p=0.01). In normal controls, the correlation between methods was significant (p=0.001) and the values measured by FPIA method was significantly higher than that by HPLG (p(0.001). Of the normal controls, male group had higher MEGX15 values than female group in both methods (in HPLC method 33.89+/-15.95 and 22.53+/- 8.36, and in FPIA method 41.48+/-16.61 and 28.81+/-7.88 ng/mL, respectively), and in female group MEGX30 values was significantly elevated compared to MEGX15 (p<0.001). CONCLUSION: Inferred from the fact that the correlation between ICG Rmax and MEGX was good, MEGX test can be considered a replacement for ICG Rmax. In healthy adults, it is considered that there is serf-related difference In the rate of lidocaine metabolism so we should pay attention to it in interpreting the MEGX results.
Adult ; Chromatography, High Pressure Liquid ; Chromatography, Liquid ; Female ; Fluorescence Polarization Immunoassay ; Healthy Volunteers ; Humans ; Indocyanine Green* ; Lidocaine ; Liver Diseases ; Male ; Mesons ; Metabolism

Laparoscopic cholecystectomy has been popularized all over the world as the treatment of choice for unnecessory symptomatic or asymptomatic gall stones. Initially, this surgery was applied to limited indications, but nowadays the indications of the surgery have been expanded to include severe, inflamed, complicated patients with gall stones, which used to be thought of as contraindications in the past. Surgeon,s technical improvement and newly devised surgical instruments made it possible to expand the limit of surgical indications for laparoscopic cholecystectomy. However, anatomical disorientation due to severe inflammed gall bladder is still the drawback to the possible occurrence of laparoscopic bile duct injury and bleeding. We have a clinical analysis of 32 cases of laparoscopic cholecystectomy for acute cholecystitis or G.B.empyema, surgical time,safety and case were evaluated. Two patients were converted to open laparotomy because of intraoperative bile duct injury and anatomical disorientation by hepatic flexure colonic interposition. As a result, we suggest that even in patients with subphrenic abscess or bile peritonitis secondary to G.B.empyema could be the indications for the laparoscopic cholecystectomy if surgeon's ability or patient's condition allow it.
Bile ; Bile Ducts ; Cholecystectomy, Laparoscopic* ; Cholecystitis, Acute ; Cholelithiasis* ; Colon ; Gallstones ; Hemorrhage ; Humans ; Laparotomy ; Peritonitis ; Subphrenic Abscess ; Surgical Instruments ; Urinary Bladder

Endoscopic sphincterotomy (E.S.T.) has relatively low complications and is the theraphy of choice in patients with common bile duct stones. It is also an useful technique for decompression of biliary tract obstruction. Thirty two cases of patients were selected according to opedrative risks: old age, severe jaundice and recurrent or retained bile duct stones after cholecystecomy from 1986 to 1988. The results were as follows, 1) In thirty two cases nf E.S.T., male to female ratio was 1:1.46. Most frequent age was older than 40 years. (male, 84.6%, female, 84.2%). 2) Out of thirty two cases, 20 cases (62.5% were under post clholecystectomy state, 12 eases (37.5%) were obstructive jaundice. 3) Spontaneous stone passage after E.S.T. was 81.3% (26 cases), and total stone remoral rate was 87.5% (28 cases), 4) Complications of E.S.T. were noted in three cases. In the two cases of bleeding, it was spontaneously improved and a case of acute pancreatitis was treated by medical care.
Bile Ducts ; Biliary Tract ; Common Bile Duct* ; Decompression ; Female ; Hemorrhage ; Humans ; Jaundice ; Jaundice, Obstructive ; Male ; Pancreatitis ; Sphincterotomy, Endoscopic*

The classic clinical manifestations of acute suppurative cholangitis were first described by Charcot in 1877 as a triad of fever(and chill),jaundice and right upper quadrant pain. In 1959,Reynolds and Dargan characterized acute suppurative cholangitis as a distinct clinical entity manifested by a clinical pentad of Charcot,s three signs plus shock and central nervous system depression.We have clinical analysis of acute suppurative cholangitis,218 cases who were admitted in Chonnam Hospital from Jan.1989 to Dec.1995.All cases were treated conservatively initially,and then delayed operation was performed when the patients were improved from the septic condition by cholangitis.
Central Nervous System ; Cholangitis* ; Humans ; Jeollanam-do ; Shock

BACKGROUND/AIMS: The transmission routes of HCV infection were not determined in the half of the HCV infected patients. So intrafamilial personal contact, sexual contact, vertical transmission and some vectors are supposed as a route of HCV infection. We investigated the prevalence of anti-HCV positivity in healthy Korean children and compared with the data from the healthy adults whether the vertical transmission is feasible. METHODS: Serum samples from 2,080 children in 8 elementary schools were tested for serum aminotransferases, hepatitis B viral markers by radioimmu- noassay, and anti-HCV by the third generation EIA. Sera from anti-HCV positive children were tested for HCV-RNA by RT-PCR. Six months later, same tests were repeated. RESULTS: Anti-HCV was positive in 17 children among 2,080(0.82%). Among 17 anti-HCV positive children, HCV-RNA was detected only in one case and the HCV genotype was type II by Okamotos classification. Anti-HCV was tested again in 7 of 17 anti-HCV positive children after 6 months later and all of these children were anti-HCV positive and additional 3 of 19 family members were anti-HCV positive. But HCV-RAN was not detected in alL CONCLUSION: Anti-HCV positive rate in children was 0.81%.
Adult ; Biomarkers ; Child* ; Classification ; Genotype ; Hepatitis B ; Humans ; Prevalence* ; Transaminases

BACKGROUND: The major transmission route of hepatitis C virus (HCV) is transfusion of blood or blood products. But transfusion history is found only in half of HCV infected patients. In half of the patients the transmission routes of HCV were not determined. We estimate the prevalence of anti HCV in family members of the patients with HCV. METHODS: We tested anti-HCV by using the second generation enzyme immunoassay and measured HCV-RNA by PCR (polymerase chain reaction). Serum samples from 135 adults who are family members of patients with anti-HCV positive liver disease were tested for serum aminotrasferase activities, hepatitis B viral markers by radioimmunoassay, and anti-HCV by EIA. RESULTS: anti-HCV positive rate in family members of the patients with HCV was 1.48% (2/135). This positive rate was not different from the studies of anti-HCV in general population in Korea (1.44%). CONCLUSION: Interfamilial transmission of HCV may probably occur, but it is uncommon being compare with other diseases such as HBV or HIV.
Adult ; Biomarkers ; Hepacivirus ; Hepatitis B ; HIV ; Humans ; Immunoenzyme Techniques ; Korea ; Liver Diseases ; Polymerase Chain Reaction ; Prevalence ; Radioimmunoassay

Hydrogen peroxide solution is commonly used for irrigating and cleaning wounds. When it is applied to tissues, catalase causes its rapid molecular degeneration with the release of oxygen bubbles. We present case report illustrating two hazards ; chemical colitis and oxygen embolus. A 29-year-old previously healthy woman presented to the bloody diarrhea and anal pain after hydrogen peroxide enema. In the colonoscopic examination, severe mucosal edema and ulceration with bleeding was noted from anus to sigmoid colon. With use of anal endosonography, multiple high level echo were noted in the internal and external anal sphincter of the upper anal canal. Microscopically, mononuclear cells were infiltrated in lamina propria and congestion. She had treatment with IV fluid, IV antibiotics and NPO. At 3rd hospital day, anal pain was disappeared. Bloody stool was disappeared next day. At 8th hospital day, mucosal edema and ulceration were disappeared on colonoscopic examination. Recovery was full and the patient was discharged at nine days after the episode.
Adult ; Anal Canal ; Anti-Bacterial Agents ; Catalase ; Colitis* ; Colon, Sigmoid ; Diarrhea ; Edema ; Embolism ; Endosonography ; Enema* ; Estrogens, Conjugated (USP) ; Female ; Hemorrhage ; Humans ; Hydrogen Peroxide* ; Hydrogen* ; Mucous Membrane ; Oxygen ; Ulcer ; Wounds and Injuries

No abstract available.
Pulmonary Artery*